J Clin Neurol.  2005 Apr;1(1):101-103. 10.3988/jcn.2005.1.1.101.

Wall-Eyed Monocular Internuclear Ophthalmoplegia (WEMINO) with Contraversive Ocular Tilt Reaction

• Jeon SB
• Chung SJ
• Ahn H
• Lee JH
• Jung JM
• Lee MC

• KMID: 2287720
• DOI: http://doi.org/10.3988/jcn.2005.1.1.101

Abstract

Wall-eyed monocular internuclear ophthalmoplegia (WEMINO) with contraversive ocular tilt reaction has not been previously reported. A 71-year-old woman suddenly developed blurred vision. Examination revealed left internuclear ophthalmoplegia, left exotropia, right hypotropia, and rightward head tilt. Magnetic resonance imaging showed a tiny infarction at the area of the left medial longitudinal fasciculus in the upper pons. WEMINO with contraversive ocular tilt reaction may be caused by a paramedian pontine tegmental infarction that selectively involves the medial longitudinal fasciculus.

Keyword

Wall-eyed monocular internuclear ophthalmoplegia (WEMINO); Internuclear ophthalmoplegia; Ocular tilt reaction

MeSH Terms

Aged
Exotropia
Female
Head
Humans
Infarction
Magnetic Resonance Imaging
Ocular Motility Disorders*
Pons

Figure

• 

  Figure 1 (A) Extraocular movements in 9 cardinal gazes. Left eye shows internuclear ophthalmoplegia with incomplete adduction, exotropia, and hypertropia. (B) Fundus photography. There are extorsion in the right eye and intorsion in the left eye. (C) Diffusion-weighted (performed 18 hours after the symptom onset) and T2-weighted MRIs (performed 9 days after onset) demonstrate a discrete infarction in the area of left MLF (arrows).

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